Diseases of the musculoskeletal system occupy an “honorable” second place in the structure of all visits to doctors, losing only to pathologies of the cardiovascular system.
Most often, we are talking about lesions of small peripheral joints: fingers, big toes, etc. Pain in the thumb can be caused by a variety of reasons, ranging from a banal bruise and ending with severe oncogenic processes. There are more questions than answers. Let us examine the question in more detail.
Causes of pain
The reasons why the big bone of the big toe hurts can be very different. Among the most common:
Arthritis. It is an inflammatory and degenerative lesion of the articular and surrounding musculoskeletal structures. It affects not the bones, but the joints. The most commonly affected are small joints of the periphery (carpal, joints of the fingers, toes). It usually affects both paired joints on two limbs at once. There are several varieties of arthritis, depending on the etiology of the process:
Gouty arthritis. It is the most likely cause of pain in the joints of the big toes, as it is they most often affects.
Psoriatic form of the disease. Acts as a complication of psoriasis. Localization, as a rule, coincides with the place of formation of psoriatic scabs.
Rheumatoid arthritis (not to be confused with rheumatism). It develops due to autoimmune damage to the body, when the immune system is not able to distinguish between "own" cells from "strangers" and begins to attack the cartilage structure.
Arthrosis Do not confuse arthritis and arthrosis, these are two completely different diseases. Osteoarthritis is characterized by endogenous (internal) origin. This disease slowly but surely leads to severe joint deformities. Often affects the small joints of the fingers, etc. Unlike arthritis, it does not affect paired joints and is not inclined to generalize the process with damage to internal organs and other joints of the body.
Toe injuries. This includes bruises, incomplete and complete fractures. In this case, the origin of the pain syndrome is known per se.
Hygroma of the joints of the thumb. Otherwise called a synovial cyst. It is formed as a result of the flow of intraarticular fluid into the surrounding tissue. It looks like a small soft seal in the joint area of the thumb. Mild to moderate.
These are the most common reasons that the big bone of the big toe hurts. In most cases, it’s not the bone that hurts, but the joints.
Concomitant symptoms and self-diagnosis
Self-diagnosis is, of course, necessary. This does not mean that, having suspected a problem, you need to run to the pharmacy and "pack" with all possible medicines. This is necessary for timely contact to a specialized specialist. What symptoms are observed with various diseases.
• Pain syndrome of varying intensity. If the bones on the big toes hurt, this is an occasion to beware. It may be arthritis. With arthritis of rheumatoid origin, the pain syndrome is intense, aching. The pain intensifies in the morning and evening time of the day and subsides during the day. With a gouty form of the disease, the pain is intense, paroxysmal, observed after eating meat and alcohol.
• Redness of the joints. It is associated with the development of inflammation and characterizes arthritis of various origins.
• Sensation of heat in the thumb. Also found in arthritis. Caused by local hyperthermia.
• Feeling of stiffness, as if wearing a tight sock. A common symptom in arthritis. It is a kind of "calling card" of this terrible disabling disease.
• Pain aggravated by walking characteristic of arthrosis. In a calm state, uncomfortable feelings come to naught.
• Injuries are the easiest to recognize. Immediately after the traumatic situation, characteristic features arise: pain, hematoma formation, blueing of the lesion site.
This is an almost comprehensive set of symptoms. If the bones on the big toes hurt, you should immediately go to the doctor.
Diagnostic measures
Sometimes it’s not easy to identify a problem. At the end of the self-diagnosis, you should go for an initial appointment with an orthopedic surgeon or, in extreme cases, a surgeon. The first professionally deals with problems with the musculoskeletal system, so it is preferable to visit an orthopedist. During the initial appointment, the doctor will ask questions regarding complaints and general condition at the moment. Having carefully fixed and performed palpation and visual assessment of the fingers, the doctor sends the patient to specialized instrumental and laboratory studies. Among them:
• X-ray of the joints of the big toes. Allows you to identify the most gross changes in the joint structures. It is prescribed as the first tool for the diagnosis of injuries, arthritis, etc. The minus of the method is a significant dependence on the professionalism of the doctors who carry out the radiography and describe the pictures.
• Ultrasound of the joints of the big toes. Conducted to assess the surrounding cartilage structures.
• MRI / CT scan. Gives detailed pictures of the study area. Due to its low availability, it is rarely used.
• Joint scintigraphy. This is a non-invasive study, during which a special radioactive isotope is injected into a patient's vein. Accumulating in healthy parts of the joints, this element allows us to evaluate the functional activity of the studied structures. In the course of carrying out reminds MRI diagnostics.
• General blood analysis. Gives a classic picture of inflammation with leukocytosis, high ESR.
• Blood test for rheumatoid factor. It is carried out in order to exclude rheumatoid arthritis.
• Blood chemistry. It allows to identify an excess of urate salts (this is characteristic of the gouty process).
• General urine analysis.
In the complex of these studies, it is enough to make an accurate diagnosis.
A bone on the big toe hurts: what to do?
What to do if a bone on the big toe hurts, only a doctor can say after a thorough diagnosis. The patient himself is free only to temporarily stop the symptoms with anti-inflammatory drugs and analgesics (Analgin + Ketorolac or Ibuprofen + Baralgin). Treatment should be comprehensive and includes drug therapy, physiotherapy or surgery (in extreme cases).
Drug therapy includes taking:
• Anti-inflammatory drugs (Nise, Nimesulide, Ketorolac, Diclofenac, etc.).
• Analgesics (Analgin, Tempalgin).
• Chondroprotectors (Structum and others). Designed to strengthen cartilage.
• Antispasmodics (in some cases).
Physiotherapy is selected by a physiotherapist. Preference is given to treatment with currents, electrophoresis, treatment with ultrasound.
Physiotherapy exercises have proven themselves well. It is important to keep in mind that both physiotherapy and exercise therapy are prescribed in the phase of remission of the underlying disease.
Surgical treatment is prescribed in extreme cases. This is the most radical method with two clear indications: the need to restore the anatomical integrity of the thumbs or the need to replace the joints. In all other cases, there is no need for such drastic measures.
Preventing Toe Problems
There are several recommendations for avoiding pain in the big toes.
• Wear comfortable, spacious shoes in size.
• It is important to maintain a healthy diet: eat more vegetables, fruits, legumes, lean meat. If gout is found, it is important to discard red meat and alcohol.
• Do not neglect preventive examinations by doctors. This is an important measure.
• At the first suspicion of diseases of the bones or joints, it is recommended to immediately consult a doctor so as not to waste precious time. For example, arthritis leads to severe disability during the first five years from the onset of the disease. Therefore, it is so important to be treated promptly.
Pain in the big toes - a common complaint. In order not to miss time, it is recommended that you visit a specialist if this symptom occurs. Fortunately, modern methods of therapy can significantly slow down degenerative processes. Complete cure occurs in most cases.
